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. 2017 Feb 28;23(8):1424-1433.
doi: 10.3748/wjg.v23.i8.1424.

Prognostic significance of preoperative and postoperative CK19 and CEA mRNA levels in peripheral blood of patients with gastric cardia cancer

Yu-Feng Qiao  1 , Chuan-Gui Chen  1 , Jie Yue  1 , Ming-Quan Ma  1 , Zhao Ma  1 , Zhen-Tao Yu  1
Affiliations

Prognostic significance of preoperative and postoperative CK19 and CEA mRNA levels in peripheral blood of patients with gastric cardia cancer

Yu-Feng Qiao et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the clinical and prognostic significance of preoperative and postoperative cytokeratin 19 (CK19) and carcinoembryonic antigen (CEA) mRNA levels in peripheral blood of patients with gastric cardia cancer (GCC).

Methods: We detected the preoperative and postoperative mRNA levels of CK19 and CEA in peripheral blood of 129 GCC patients by using reverse transcription-polymerase chain reaction and evaluated their clinical and prognostic significance by univariate Kaplan-Meier survival analysis and multivariate Cox proportional hazard analysis. A new prognostic model which stratified patients into three different risk groups was established based on the independent prognostic factors.

Results: Elevated preoperative and postoperative CK19 and CEA mRNA levels in peripheral blood of GCC patients were associated with lymph node metastasis. Univariate analysis showed that tumor size, histological grade, depth of tumor invasion, lymph node metastasis, preoperative CK19 mRNA, and preoperative and postoperative CEA mRNA levels were correlated with the prognosis of GCC patients. The multivariate analysis showed that lymph node status (P = 0.018), preoperative CK19 (P = 0.035) and CEA (P = 0.011) mRNA levels were independent prognostic factors for overall survival (OS). The 5-year OS rates for the low-, intermediate-, and high-risk groups were 48.3%, 22.6%, and 4.6%, respectively (P < 0.001).

Conclusion: Elevated preoperative CK19 and CEA mRNA levels may be regarded as promising biomarkers for predicting lymph node metastasis and poor prognosis in patients with GCC. This new prognostic model may help us identify the subpopulations of GCC patients with the highest risk.

Keywords: Carcinoembryonic antigen; Clinicopathological factor; Cytokeratin 19; Gastric cardia cancer; Prognosis.

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Conflict of interest statement

Conflict-of-interest statement: We have no financial relationships to disclose.

Figures

Figure 1
Figure 1
Receiver operating characteristic curves for preoperative and postoperative cytokeratin 19 and carcinoembryonic antigen mRNA levels in patients with gastric cardia cancer according to overall survival. A: Preoperative CK19 mRNA level; B: Postoperative CK19 mRNA level; C: Preoperative CEA mRNA level; D: Postoperative CEA mRNA level. AUC: Area under the curve; CK19: Cytokeratin 19; CEA: Carcinoembryonic antigen; ROC: Receiver operating characteristic.
Figure 2
Figure 2
Kaplan-Meier survival curves according to preoperative and postoperative cytokeratin 19 and carcinoembryonic antigen mRNA levels in patients with gastric cardia cancer. A: Preoperative CK19 mRNA level; B: Postoperative CK19 mRNA level; C: Preoperative CEA mRNA level; D: Postoperative CEA mRNA level. P values were calculated by the log-rank test and P < 0.05 denoted significance. OS: Overall survival; CK19: Cytokeratin 19; CEA: Carcinoembryonic antigen.
Figure 3
Figure 3
Cumulative survival curves for 129 patients with gastric cardia cancer according to risk groups by Kaplan-Meier survival analysis. The 5-year OS rates for the low-, intermediate-, and high-risk groups were 48.3%, 22.6% and 4.6%, respectively (P < 0.001). OS: Overall survival.
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